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Your Foot Book Plantar Fasciitis Plantar Fasciitis - The Most Common Cause of Heel Pain
In times past, this condition was noted as a "heel spur." Some people with heel pain have a bony spur attached to the heel near the area of discomfort. We now know that these heel spurs are present in a large portion of the population without any symptoms, and only 57% of doctor's patients with heel pain possess such a spur. This spur is also located higher on the heel, and rarely is the source of heel pain. Operations and treatment designed to remove the spur, therefore, have limited success. Common symptoms of plantar fasciitis are severe pain in the bottom of the heel, especially in the morning with your first steps, or upon getting up after sitting for a while. The pain may be sharp, burning and cause a limp. Who Gets Plantar Fasciitis? Plantar fasciitis may be seen with overuse (running and jumping athletes), and direct trauma (walking or jumping on a hard object). Overuse due to a tight Achilles tendon or the increased force caused by obesity also can result in heel pain. Certain inflammatory medical conditions, as noted above, also can cause irritation of the plantar fascia. Certain foot types (flat feet or the opposite, high-arch feet) sometimes are prone to this condition. The Treatment of Plantar Fasciitis Fortunately, the treatment of heel pain and plantar fasciitis usually is conservative. Surgery is rarely, if ever, needed for the treatment of this condition. We have used a conservative treatment protocol for thousands of heel pain sufferers with excellent success. However, it does require some work on your part. There is no "magic bullet" to immediately relieve heel pain, while ignoring the underlying cause. The validity of such an approach has been confirmed by a national multi-center study conducted by the American Orthopedic Foot and Ankle Society. Treatment protocols often include anti-inflammatory medication (Motrin, Advil, Naprosyn, etc.), and physical therapy modalities such as ice, ultrasound and heel massage. Foot muscle strengthening exercises and stretching exercises for both the Achilles tendon and plantar fascia are important in short-and long-term relief for plantar fasciitis. Both the longer gastrocnemius muscle (which extends above the knee) and the shorter soleus muscle (which begins in the calf) combine to make the Achilles tendon, and must be stretched. The plantar fascia usually is tight and must be stretched as well to provide long-term relief. The stretching exercises, along with the pro stretch device, are very helpful in reducing heel pain. People with severe early-morning pain may benefit from wearing a dorsiflexion AFO (ankle-foot orthotic) brace to maintain stretch on the plantar fascia and Achilles tendon at night. Often called a night splint . Heel pain sufferers with a flexible flat foot or high arch cavus-type foot may benefit from shock absorbing heel cups or molded orthotic arch supports. Contrast baths (ice alternated with heat), as well as other physical therapy modalities such as ultrasound and Rx steroid, have proved helpful in plantar fasciitis. Cortisone injections into the heel should be used sparingly after other forms of conservative treatment. Repeated cortisone injections in the heel may cause withering or atrophy of the fat pad, which is an irreversible problem. Putting the foot in a cast to rest the plantar fascia for 4-6 weeks sometimes is used in very resistant cases. Finally, an organized weight-loss program may be necessary to obtain full relief in patients who are overweight. Surgery should only be necessary in less than 1% of all cases, since conservative treatment usually will alleviate pain, and surgical treatment sometimes can produce other more severe problems. Hard work and patience sometimes are necessary for heel pain sufferers. In general, the longer symptoms have existed prior to treatment, the longer it will take for symptoms to improve with treatment. In summary, heel pain, just like low back pain, usually can be treated conservatively, and requires the education of the patient in treating the underlying biomechanical problem for both short-term and long-term relief. Foot Menders can supply a wide variety of items necessary for the successful treatment of heel pain. Further help may be obtained from your physician or physical therapist. This material does not constitute medical advice. It is intended for informational purposes only. Foot Menders will not answer medical questions via email. Please consult a physician for specific treatment recommendations. |
The
most common cause of heel pain , by far, is plantar fasciitis. On
the bottom (plantar) surface of the foot, a thick ligament-like
band (fascia) runs from the toes to the heel. This plantar fascia
stretches with standing, running and jumping; and may become irritated
where it attaches to the heel, producing heel pain and plantar fasciitis.